Table 2.

Comparison of Themes and Domains Identified from 22 Qualitative Studies on Patients Perspectives of Quality Nursing Care

Qualitative study	Sample/Question	Competence	Caring	Professionalism	Demeanor	Others
1. Taylor et al. (1991) Content analysis (USA)	70 patients (and 70 significant others). 2 weeks after discharge from a hospital. Telephone interview. ”Describe what you think quality nursing care is.”	Total patient care Patient education Effective communication Knowledgeable Technically competent	Patient-centered care Caring	Professional character Best possible care	Kind, nice, friendly Flexible Efficient Helpful Gentle Courteous Conscientious Confident	Family involvement Effective organization and management Patient environment
2. Häggman- Laitila & Åstedt-Kurki (1994) Content analysis (Finland)	60 in-hospital patients and 40 outpatients. Interview. “What is quality of a good nurse and a poor nurse?”	Careful, observant, accurate Inquire patient’s needs Offer alternatives Sensitive Provide information Cooperative with other team members Fulfilling patients’ needs	Treat patient as an individual Interest in patient’s feelings/experiences Introduce self to patient Regard patient as an equal co-partner Discuss with patients other matters than their illness	Treat patient equally, justly Honest Protect patient’s intimacy and confidentiality Assume responsibility	Kind, gentle Genuine Good humor Conscientious
3. Wilde et al. (1993) Grounded Theory (Sweden)	20 hospitalized patients with infectious disease. Interviews. “What are important issues in the care you received? Positive or negative care?”	Medical-technical competence (have knowledge and proficient)	Identity-oriented approach (show interest and commitment to the patient as a person, symmetrical relationship, mutual understanding)	Identity-oriented approach (inform patient who is responsible for his care)	Identity-oriented approach (warm, nice, honest, sincere, cheerful, pleasant, kind, decent)	Physical and administrative environment (equipment available, clean, comfortable, safe environment, access to TV phone.)
4. Burfitt et al. (1993) Phenomenologi cal study (USA)	13 patients within 48 hours of transfer from ICU. Interviews. “Describe nurses caring in ICU.”	Attentiveness Highly skilled practice Lifesaving behaviors	The basics and beyond Nurturing Mutuality (feel with patient) Compassionate
5. Fosbinder (1994) Qualitative analysis (USA)	40 patients in ortho/chest/cardiac wards in a teaching hospital. Observation and interviews. “What happened and how you felt about care?”	Translating (informing, explaining, instructing, teaching) Establishing trust (being in charge, anticipating needs, being prompt, following through)	Getting to know you (personal sharing, clicking) Going the extra mile (being a friend, doing the extra)	Establishing trust (enjoying the job)	Getting to know you (humor, friendly)
6. Beech & Norman (1995) Critical Incident Technique (UK)	24 psychiatric patients in2 psychiatric wards. Interviews. “High and low quality psychiatric nursing care incident.”	Handling violence and disturbance (deftness)	Communicating caring (being available, listening, actions explained) Respect Nurses attribute (being caring, showing an interest in people)	Nurses attribute (enthusiasm for the job)	Ward atmosphere Attributes (friendliness, being cheerful, kindness, having patience, tolerance)	Nursing staffing
7. Milburn et al. (1995) Grounded theory (UK)	30 patients in med/oncology wards. 25 follow-up 6 weeks after discharge (5 died before 2nd interview). Interviews. “What care would you like from a nurse?”	Knowledge (physical care, theoretical knowledge) Information giving	Listening/talking time Being there for the patient Psychological care Respect for the individual (personal touch)		Atmosphere: social environment (kind, caring, friendly, calm, smiling, cheerful nurse)	Continuity of care from same nurses
8. Thomas et al. (1995) Content analysis (UK)	100 medical/surgical patients during and/or after discharge. Interviews and/or focus group. “What was an example of good nursing?”	Attentiveness Availability Information giving Nurses’ knowledge (know about patient as individual and their treatment)	Individual treatment	Professionalism (conduct and composure, not show negative emotions, never complain, equal treatment)	Nurses’ manner Openness/informality	Ward organization (continuity of care, same nurse, good communication between shifts) Ward environment (food, noise, temperature, lighting)
9. Lynn & Sidani (1995) Grounded theory (USA)	25 med/surg/ob/ped patients in medical centers. Interviews How do you describe or define good nursing care?”	Being instructive/facilitative Vigilant Technically competent	Being with patients and family Communicating that the patient is the nurses’ first concerns Getting to know the patient Respect as a person		Being patient	Environment
10. Irurita (1996) Grounded theory (Australia)	23 patients following their discharge from >5 days hospital stay. Interviews. To explore quality care from the hospitalized patient’s perspective.	Firm-hand care (technical competence, providing adequate relevant information in timely manner, facilitate patient independence)	Soft-hand care (go extra, being there, use of touch, empathy and compassion)	Firm-hand care (equalize the power imbalance) Soft-hand care (Nothing is too much trouble for them, be a patient advocate)	Soft-hand care (kind)
11. Walker et al. (1998) Grounded theory (UK)	18 patients 4–6 weeks after inpatient care or day surgery. Interviews. To understand patients’ experiences of hospitalization (not limited to nursing care).	Feeling adequately informed	Feeling valued as an individual (staff care about patients, know how they feel, and have time for them) Interpersonal skill Reciprocal attitude of caring			Feeling at home (physically, environmentally)
12. Middleton & Lumby (1999) Content analysis (Australia)	16 orthopedic male patients 4.5month (average) after surgery. Focus group. “What was/not done for you by the nursing staff that made differences to your outcome?”	Patient-Controlled Analgesia Heel care Explanation about treatment Inform patients about the treatment				Comfortable environment (cold shower, control noise, access to drinks/phone)
13. Redmond & Sorrell (1999) Phenomenological research (USA)	20 patients 1–2 weeks after discharged from acute rural hospitals. Interviews. “Describe an experience that indicates quality (poor) care.”	Knowledgeable watchfulness (monitoring the physical status, sensing when they need support and comfort, explanation)	Knowledgeable watchfulness (caring) Thoughtful presence	Knowledgeable watchfulness (professional judgment)
14. Oermann (1999) Qualitative analysis (USA)	239 consumers recruited from clinic waiting rooms and in neighborhoods. Interviews. “Describe quality nursing care and experiences that you felt represented quality care.”	Competent and skilled Communicate effectively with patients Teach patients about their condition, treatment, medication, and selfcare	Concerned about patients Demonstrating caring behaviors Treat patients with respect
15. Redfern & Norman (1999) Critical Incident Technique (UK)	96 patients from elderly/medical/surgical wards. Interviews. Perception of high and low quality nursing care.	Monitoring/assessment/documentation/information giving Skillful treatment Efficiency and thoroughness Anticipation and reaction in care Comprehensive clinical knowledge Health education Effective crisis management Effective communication to ensure continuity of care	Have time for patient Show concern, take time to talk Take a personal interest in patients as individuals Engage with them as partners	Give impression of nothing was too much trouble Maintain dignity, ensure confidentiality, respect patient’s wish, no value judgments, keep promise Teaching nurses, leadership, critique Work ethics/philosophy of care Take pride in their work	Friendly, approachable, not impose unnecessary restrictions Respect, courtesy, affectionate, humor Even-tempered, calm	Equipment. adequate resources, support service, and time to do a good job
16. Radwin (2000) Grounded theory (USA)	22 oncology patients (include newly diagnosed, chronic, and terminal stage). Interviews. “Describe quality nursing care, and episode of non/excellent nursing care.”	Professional knowledge and technical competence Attentiveness (address patient needs promptly) Coordination (coordination of care and teamwork)	Partnership Individualization Rapport (patients know about the nurse) Caring (express concern, nurturing, remember the patient)			Continuity
17. Attree (2001) Grounded theory (UK)	34 acute medical patients and 7 relatives in general hospitals. Interviews. “Describe examples of care which you thought was good quality and which was not.”	Relate to need Need anticipated Open communication and information passage Time availability and accessibility	Patient focused Individualized Inclusive care Sociable relationship Bond/rapport Patients as people Concern Compassion and sensitivity shown	Help offered willingly	Kind Cheerful Happy Smiling Showed good humor Unhurried manner
18. Larrabee & Bolden (2001) Qualitative analysis (USA)	199 hospitalized medical/surgical patients. Interviews. “What is good nursing care?”	Provide for my needs Being competent Provide prompt care	Care about me		Treat me pleasantly
19. Stichler & Weiss (2001) Content analysis (USA)	39 women in a hospital- based women’s health care clinic. Interviews “What is quality care? (not specific for nursing care.)”	Competent staff (technical skill, accuracy, effective treatments) Timeliness (timely response, efficient, be ready, keep things moving on schedule)	Personalized caring (Take a personal interest in me, treat me right, helpful)		Display strong professional demeanor Friendly	Environment/facility (clean and comfortable, privacy, familiar and home-like environment)
20. Thorsteinsson (2002) Phenomenological study (Iceland)	11 patients with chronic disease with hospitalization experiences. Interviews. “What is quality of nursing care?”	Clinical competence Sensitivity to patients’ needs Patient teaching	Genuine concern	Trust and honesty	Kind Good attitude and manner (joyful, warm, tender, smiling, positive, polite, understanding) Use humor	Ancillary factors (hotel factors)
21. Redman & Lynn (2005) Qualitative analysis (USA)	20 medical/surgical patients in academic medical center. Interviews. “What are your expectations for care?”	Provider competence (careful, accurate, timely treatments, thorough, knowledgeable, well informed). Education/communication Anticipation of needs	Respect and caring Individualization of care	Provider behavior (act professional, leave personal problems at home)	Provider behavior (humor)	Hotel services
22. Izumi et al. (2006) Phenomenological study (Japan)	26 oncology patients who have experiences of hospitalization. Interviews. “What are characteristics and attributes of good nurses?”	Professional Competence (technically skillful, capture patients needs, ability to make judgment, communication, having knowledge.)	Presenting oneself as a person Interested in a patient as a person Caring for a patient as a precious person	Professional disposition (Have pride and passion for doing a good job, responsible, keep promise, take responsibility, strive to improve skills and knowledge)	Good persons (cheerful, kind, smiling, warm, gentle, compassionate, sensitive, hopeful, have sense of humor, courteous)

Note: Findings in this table are not always presented in comparable/symmetrical terms. To avoid misinterpretation of the findings, the terms used in the articles have been used in the table rather than modifying them for grammatical consistency.